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Tuberculosis presenting as multiple intramuscular nodules in a child: a case report

INTRODUCTION: Tuberculosis is a global health problem that mostly affects people in developing countries. Tuberculosis can occur in various organ systems and may present with diverse manifestations in the same system. Primary muscular tuberculosis is a very rare condition in both adults and children...

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Autores principales: Dhakal, Ajaya Kumar, Shah, Subhash Chandra, Shrestha, Devendra, Banepali, Niroj, KC, Geetika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381512/
https://www.ncbi.nlm.nih.gov/pubmed/25885776
http://dx.doi.org/10.1186/s13256-015-0543-6
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author Dhakal, Ajaya Kumar
Shah, Subhash Chandra
Shrestha, Devendra
Banepali, Niroj
KC, Geetika
author_facet Dhakal, Ajaya Kumar
Shah, Subhash Chandra
Shrestha, Devendra
Banepali, Niroj
KC, Geetika
author_sort Dhakal, Ajaya Kumar
collection PubMed
description INTRODUCTION: Tuberculosis is a global health problem that mostly affects people in developing countries. Tuberculosis can occur in various organ systems and may present with diverse manifestations in the same system. Primary muscular tuberculosis is a very rare condition in both adults and children, and tuberculosis of various muscle groups presenting as intramuscular nodules is an even more uncommon presentation. CASE PRESENTATION: A 9-year-old Asian girl presented with multiple painless, gradually progressive swellings over different parts of her body for 3 months with no history of contact with tuberculosis. A physical examination was normal except for multiple swellings in her right forearm, a single swelling in her interscapular region and multiple swellings in her right calf. Ultrasonography of swellings revealed multiple nodules in the intramuscular layer. Excisional biopsies performed from two different sites revealed swellings in muscular layers and histopathology showed granulomatous inflammation with caseous necrosis consistent with tuberculosis. The child was started on antitubercular therapy after which the swellings resolved; she was kept on regular follow up. CONCLUSIONS: Intramuscular nodules in multiple muscular sites may be the presenting symptoms of tuberculosis of the muscles. Tuberculosis of skeletal muscles should be considered in a differential diagnosis when presented with single or multiple masses even when a chest X-ray is normal and there is no evidence of tubercular foci elsewhere in the body.
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spelling pubmed-43815122015-04-02 Tuberculosis presenting as multiple intramuscular nodules in a child: a case report Dhakal, Ajaya Kumar Shah, Subhash Chandra Shrestha, Devendra Banepali, Niroj KC, Geetika J Med Case Rep Case Report INTRODUCTION: Tuberculosis is a global health problem that mostly affects people in developing countries. Tuberculosis can occur in various organ systems and may present with diverse manifestations in the same system. Primary muscular tuberculosis is a very rare condition in both adults and children, and tuberculosis of various muscle groups presenting as intramuscular nodules is an even more uncommon presentation. CASE PRESENTATION: A 9-year-old Asian girl presented with multiple painless, gradually progressive swellings over different parts of her body for 3 months with no history of contact with tuberculosis. A physical examination was normal except for multiple swellings in her right forearm, a single swelling in her interscapular region and multiple swellings in her right calf. Ultrasonography of swellings revealed multiple nodules in the intramuscular layer. Excisional biopsies performed from two different sites revealed swellings in muscular layers and histopathology showed granulomatous inflammation with caseous necrosis consistent with tuberculosis. The child was started on antitubercular therapy after which the swellings resolved; she was kept on regular follow up. CONCLUSIONS: Intramuscular nodules in multiple muscular sites may be the presenting symptoms of tuberculosis of the muscles. Tuberculosis of skeletal muscles should be considered in a differential diagnosis when presented with single or multiple masses even when a chest X-ray is normal and there is no evidence of tubercular foci elsewhere in the body. BioMed Central 2015-03-28 /pmc/articles/PMC4381512/ /pubmed/25885776 http://dx.doi.org/10.1186/s13256-015-0543-6 Text en © Dhakal et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Dhakal, Ajaya Kumar
Shah, Subhash Chandra
Shrestha, Devendra
Banepali, Niroj
KC, Geetika
Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title_full Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title_fullStr Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title_full_unstemmed Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title_short Tuberculosis presenting as multiple intramuscular nodules in a child: a case report
title_sort tuberculosis presenting as multiple intramuscular nodules in a child: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381512/
https://www.ncbi.nlm.nih.gov/pubmed/25885776
http://dx.doi.org/10.1186/s13256-015-0543-6
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